By Jim Thomas, PhD and Mamadou Alimou Barry, MS, MPH, DPharm
When routine data are lacking, or are not used, the results can be lower-quality services, weak infection prevention and control responses, lack of skilled health workers available where they are needed, and weak supply chains for drugs and equipment. Poor data or a lack of data will ultimately contribute to poor planning, policies, and resource allocation in the health sector. These factors contribute to poor health outcomes for people.
To contribute to improved health, a new series of tools looks at multiple aspects of routine health information systems (RHIS)—data quality, use of information, and technical, organizational, and behavioral aspects of RHIS performance. With USAID’s support, MEASURE Evaluation has revised the Performance of Routine Information Systems Management (PRISM) tools to help countries identify gaps in their routine health information system (RHIS). This new, more comprehensive PRISM Series is useful for designing, strengthening, and evaluating RHIS performance and developing a plan to put the results of a PRISM assessment into action to support evidence-based decisions in the health sector. A holistic action plan to address the multiple factors that affect RHIS performance needs to include technical interventions, organizational interventions that focus on the setting where people work, and behavioral interventions targeting the human resources needed to implement the action plan.
The PRISM framework (2009 version) was developed by MEASURE Evaluation for global use in assessing RHIS performance, whether at public, private, or community-level health facilities and institutions. The new PRISM series supports this and more—it covers more RHIS issues, addresses user needs more effectively, and is more tailored to context and system levels where it is implemented.
Why revise it? The impetus was the experience we gained implementing the tool and a desire to improve user friendliness and management guidance for users. For instance, the original PRISM Organizational Behavioral Assessment Tool (OBAT) used the same assessment questions at all levels of a health system. Yet, it became apparent that questions should be tailored to the functions of each level—i.e., a facility staff member would need different skills than a district manager.
We also added new components. While improving all the PRISM tools during the revision based on experiences and lessons learned during implementation, we added an electronic tool to assess both the functionality of the data management platform and its usability by end users. The revised tool also, for example, addresses capacity for data management and visualization, data use, and staff incentives and motivation. It also integrates part of a Data Quality Review (DQR) into the diagnostic tool, which can now be used for harmonizing the data quality approach within PRISM.
